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Anatomy-Specific Pancreatic Stump Management to Reduce the Risk of Pancreatic Fistula After Pancreatic Head Resection.
http://hdl.handle.net/10069/24403
http://hdl.handle.net/10069/24403dd7abe16-32ff-4af6-9814-42749c762372
名前 / ファイル | ライセンス | アクション |
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WJS33_2166.pdf (1.0 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2010-11-01 | |||||
タイトル | ||||||
タイトル | Anatomy-Specific Pancreatic Stump Management to Reduce the Risk of Pancreatic Fistula After Pancreatic Head Resection. | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pancreaticojejunostomy | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pancreatic stump | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | anatomy | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pancreatic | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pancreatic fistula | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Tajima, Yoshitsugu
× Tajima, Yoshitsugu× Kuroki, Tamotsu× Tsuneoka, Noritsugu× Adachi, Tomohiko× Kosaka, Taiichiro× Okamoto, Tatsuya× Takatsuki, Mitsuhisa× Eguchi, Susumu× Kanematsu, Takashi |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | BACKGROUND: The anatomical status of the pancreatic remnant after a pancreatic head resection varies greatly among patients. The aim of the present study was to improve management of the pancreatic remnant for reducing pancreatic fistula after pancreatic head resection. METHODS: Ninety-five consecutive patients who underwent an end-to-side, duct-to-mucosa pancreaticojejunostomy after pancreatic head resection were included in the study. To approximate the pancreatic stump to the jejunum, the transfixing and interrupted suture techniques were used in 51 and 44 patients, respectively. We modified the interrupted suture technique according to the anatomical status of the pancreatic remnant, i.e., the shape of the pancreatic stump and the location of the pancreatic duct. RESULTS: There was no operative mortality in this study. Overall, 14 patients (15%) developed a clinically relevant pancreatic fistula. Certain anatomical features, including a small pancreatic duct, a soft, nonfibrotic pancreatic gland, and a pancreatic duct adjacent to the posterior cut edge, were significantly associated with pancreatic fistula. The fistula rate in the interrupted suture group was 7%, lower than that (22%) in the transfixing suture group (P = 0.036), and it was not influenced by pancreatic anatomy. Multivariate analysis identified a nonfibrotic pancreas (versus fibrotic pancreas; odds ratio [OR] 12.58, 95% CI 1.2-23.9; P = 0.001), a soft pancreas (versus hard pancreas; OR 4.67, CI 1.2-51.1; P = 0.006), and the transfixing suture technique (versus interrupted suture technique; OR 9.91, CI 1.7-57.5; P = 0.003) as significant predictors of clinically relevant pancreatic fistula. CONCLUSIONS: Pancreatic anastomosis modified according to the pancreatic anatomy is effective in reducing the risk of pancreatic fistula formation with end-to-side, duct-to-mucosa pancreaticojejunostomy after pancreatic head resection. | |||||
書誌情報 |
World journal of surgery 巻 33, 号 10, p. 2166-2176, 発行日 2009-10 |
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出版者 | ||||||
出版者 | SpringerLink | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 14322323 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AA0089099X | |||||
PubMed番号 | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | PMID | |||||
関連識別子 | 19657576 | |||||
DOI | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1007/s00268-009-0179-z | |||||
権利 | ||||||
権利情報 | c Springer | |||||
権利 | ||||||
権利情報 | The original publication is available at www.springerlink.com | |||||
著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | World journal of surgery, 33(10), pp.2166-2176; 2009 |